Children In Low-income Families Research Articles

In Whose Best Interest? Parental Hesitancy toward the COVID-19 Vaccine for Children in Japan: A Literature Survey Study

In early February 2022, the Japanese government sent COVID-19 vaccine vouchers to children ages 5–11. Using keywords obtained from the voucher, the frequently asked questions section, and experts, we descriptively analyzed the advantages and disadvantages of vaccination for children and their parents through a web-based literature survey of media articles and government homepage statements in Japan. For children, vaccination helps prevent severe symptoms and may be particularly beneficial for children in low-income families by lowering the rate of suicide and at-home child abuse. For parents, not vaccinating their child allows them to fulfill a more traditional role as a parent (mothers in particular), reduces the gender gap for mothers, and provides greater peace of mind about their child’s future fertility. We also examined the governmental vaccination campaigns targeting children from public health perspectives. We argue that the letter accompanying the vaccine voucher should clearly emphasize that further transmission will be prevented, reducing domestic infection. In addition to the biological dimensions of COVID-19 in Japan, we emphasize cultural issues and hope that these can be useful for other countries as they create their own vaccination strategies. Public health in Japan could be promoted if all citizens, regardless of age, acquired fundamental knowledge and skills, the motivation to learn, and the ability to utilize knowledge and skills and think, judge, and express personal ideas.

Support Strategy for Executive Function in Children of Low-Income Families: The Marshmallow Test Has a Learning Value

Executive function (EF) development is an important part of infancy and childhood, promoting success in later life. Developing targeted methods is desirable to enable EF. There is an urgent need for easily implementable proposals to ameliorate educational disparities between income groups. EF is a skill that its possessor can use to inhibit thoughts and emotions. There is a relationship between EF and the prefrontal cortex. The Wechsler Intelligence Scale for Children’s (WISC-IV) Working Memory Index (WMI) task for thinking and the marshmallow test for emotions have been used to measure EF, but these tests themselves carry a load of inhibitions. Therefore, we can assume a natural value in learning to improve on the test. The marshmallow test does not require parental expertise in preparation or implementation, and it entails little financial burden. If there is a potential value in learning how to do better on the test, it will be easy for parents in low-income families to help their children improve. I examined whether the marshmallow test itself can support EF. Measurements of brain activity in the prefrontal cortex over 8 days showed that the marshmallow test was more active than the WMI task or the abacus task. Therefore, the results suggest that continued use of the marshmallow test can support EF even in low-income families.

Association of the Healthy, Hunger-Free Kids Act of 2010 With Body Mass Trajectories of Children in Low-Income Families

Implemented in 2012, the Healthy, Hunger-Free Kids Act of 2010 (HHFKA) increased nutritional requirements of the National School Lunch Program (NSLP) to reverse the potential role of the NSLP in childhood obesity. To evaluate whether associations between the free or reduced-price NSLP and body mass growth differed after implementation of the HHFKA. This cohort study used data from 2 nationally representative cohorts of US kindergarteners sampled in 1998 to 1999 and 2010 to 2011 and followed up for 6 years, through grade 5, in the Early Childhood Longitudinal Study Kindergarten Class of 1998-1999 (ECLS-K:1999, in 2003-2004) and Kindergarten Class of 2010-2011 (ECLS-K:2011, in 2015-2016). In total, 5958 children were selected for analysis from low-income families eligible for the free or reduced-price NSLP (household income <185% of the federal poverty level) who attended public schools and had no missing data on free or reduced-price NSLP participation or on body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) at kindergarten or grades 1 and 5. Data were analyzed from January 1 to September 7, 2021. Cross-cohort comparison of before vs after implementation of the HHFKA for free or reduced-price NSLP participation at kindergarten and grades 1 and 5. Body mass index difference (BMID) from obesity threshold was the difference in BMI units from the age- and sex-specific obesity thresholds (95th percentile) and is sensitive to change at high BMI. Multigroup models by cohort included weights to balance the distribution of the 2 cohorts across a wide range of covariates. A Wald test was used to assess whether associations differed between the cohorts. In the final analysis, 3388 children in ECLS-K:1999 (1696 girls [50.1%]; mean [SD] age at baseline, 74.6 [4.3] months) and 2570 children in ECLS-K:2011 (1348 males [52.5%]; mean [SD] age at baseline, 73.6 [4.2] months) were included. The best fitting model for BMID change by free or reduced-price NSLP participation across the cohorts included fixed and time-varying associations. Before HHFKA implementation, grade 5 free or reduced-price NSLP participants had higher BMID, adjusted for their prior BMID trajectory, than nonparticipants (β = 0.54; 95% CI, 0.27-0.81). After HHFKA implementation, this association was attenuated (β = -0.07; 95% CI, -0.58 to 0.45), and grade 5 associations were different across cohorts (χ21 = 4.29, P = .04). In this cohort study using cross-cohort comparisons, children from low-income families who participated in the free or reduced-price NSLP had a higher likelihood of progression to high BMI that was no longer observed after HHFKA implementation. This finding suggests that the HHFKA may have attenuated the previous association of the NSLP with child obesity disparities.

Oral Health and Academic Achievement of Children in Low-Income Families

Low-income children have higher rates of unmet oral health needs. Prior research suggests that poor oral health is associated with lower academic performance but uses cross-sectional and mostly parent-reported measures. This study examined the association between oral health during the first 5 y of life and subsequent academic achievement for low-income children. Birth certificates of children born in Iowa in 1999–2009 were linked to Medicaid enrollment and dental claims data in 1999–2014 and reading and math standardized school test scores for grades 2 through 11. The following oral health measures were examined: having minor dental treatments (mostly surface fillings), major dental treatments (mostly crowns and pulpotomy) or extractions, and comprehensive dental exams during the first 5 y of life. Regression models were estimated adjusting for sociodemographic factors, early infant health, and school district effects. The sample included 28,859 children and 127,464 child-grade observations. In total, 21%, 12%, and 62% of children had at least 1 minor dental treatment, 1 major treatment or extraction, and 1 comprehensive dental exam in the first 5 y of life, respectively. Children who received a minor dental treatment had higher reading and math scores by 1 percentile (95% CI, 0.09–1.9) and 0.9 percentiles (95% CI, 0.02–1.8), respectively. Children who had a major dental treatment or extraction had lower reading and math scores by 2.4 (95% CI, −3.5 to −1.4) and 1.8 (95% CI, −2.8 to −0.8) percentiles. Children who had a comprehensive oral exam had higher reading and math scores by 0.7 (95% CI, 0.06–1.4) and 1.2 (95% CI, 0.6–1.9) percentiles. The findings suggest that children’s oral health before school age is associated with academic achievement later during school years.

Segregating Suspected Child Maltreatment from Non-Child Maltreatment Injuries: A Population-Based Case-Control Study in Taiwan.

Objective: To identify the differential patient characteristics, injury types, and treatment outcomes between hospitalized child abuse and non-child abuse injuries in Taiwan. Methods: Using the data from the National Health Insurance Research Database, we selected a total of 1525 patients under the age of 18 that were diagnosed with child abuse, as well as an additional 6100 patients as a comparison group. Chi-square test, Fisher exact test, and independent samples t-test were used to compare the differences between the abused children and the non-abuse-related injured children. The multivariate conditional logistic regression was performed to measure the risk factor of child maltreatment in injured children. Results: Intracranial injury was more frequent in the child abuse group than it was in the non-child abuse group (35.0% vs. 8.2%; p < 0.001). Children in the child abuse group tended to stay longer in the hospital and incur higher medical expenses (8.91 days vs. 4.41 days and USD 2564 vs. USD 880, respectively). In multivariate analysis, the Adjusted Odds Ratio (Adjusted OR) of abuse resulting in an injury for children in low-income families is 1.965 times higher than those in non-low-income families (p < 0.001). Children living in high urbanization areas had a significantly higher probability of being abused than those living in low urbanization areas (p < 0.001). Conclusion: Children under the age of 1 who were hospitalized with severe intracranial injuries are highly at risk for child maltreatment. Moreover, numerous high-risk environmental factors were observed in child abuse cases, including living in urban areas, families with low income, and seasonality, as child maltreatment cases occur more frequently in autumn.

The Longitudinal Associations Between Paternal Incarceration and Family Well-Being: Implications for Ethnic/Racial Disparities in Health.

Ethnic/racial minority children in the United States are more likely to experience father loss to incarceration than White children, and limited research has examined the health implications of these ethnic/racial disparities. Telomere length is a biomarker of chronic stress that is predictive of adverse health outcomes. This study examined whether paternal incarceration predicted telomere length shortening among offspring from childhood to adolescence, whether maternal depression mediated the link, and whether ethnicity/race moderated results. Research participants included 2,395 families in the Fragile Families and Child Wellbeing study, a national and longitudinal cohort study of primarily low-income families from 20 large cities in the United States. Key constructs were measured when children were on average ages 9 (2007-2010) and 15 (2014-2017). Children who experienced paternal incarceration exhibited shorter telomere lengths between ages 9 and 15, and changes in maternal depression mediated this finding. Specifically, mothers who experienced a partner's incarceration were more likely to have depression between children's ages 9 and 15. In turn, increases in maternal depression between children's ages 9 and 15 predicted more accelerated telomere length shortening among children during this period. Paternal incarceration was more prevalent and frequent for ethnic/racial minority youth than for White youth. Paternal incarceration is associated with a biomarker of chronic stress among children in low-income families. Rates of paternal incarceration were more prevalent and frequent among Black American and multiethnic/multiracial families than among White Americans. As a result, the mass incarceration crisis of the criminal justice system is likely shaping intergenerational ethnic/racial health disparities.

Is it possible to model the impact of calorie-reduction interventions on childhood obesity at a population level and across the range of deprivation: Evidence from the Avon Longitudinal Study of Parents and Children (ALSPAC)

BackgroundSimulated interventions using observational data have the potential to inform policy and public health interventions where randomised controlled trials are not feasible. National childhood obesity policy is one such area. Overweight and obesity are primarily caused by energy-rich and low-nutrient diets that contribute to a positive net energy imbalance. Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), we investigated whether causal modelling techniques could be applied to simulate the potential impact of policy-relevant calorie-reduction interventions on population prevalence and inequalities in obesity in childhood.MethodsPredicted probabilities of obesity at age 11 (UK90 cut offs) were estimated from logistic marginal structural models (MSM) accounting for observed calorie consumption at age 7 and confounding, overall and by maternal occupational social class. A series of population intervention scenarios were modelled to simulate daily calorie-reduction interventions that differed in effectiveness, targeting mechanism and programme uptake level.ResultsThe estimated effect of maternal social class on obesity after accounting for confounding and observed calorie intake was provided by the controlled direct effect (CDE), in which, 18.3% of children were living with obesity at age 11 years,. A universal simulation to lower median intake to the estimated average requirement (EAR) (a 6.1% reduction in daily calories) with 75% uptake reduced overall obesity prevalence by 0.6%; there was little impact on inequalities. A targeted intervention to limit consumption to the EAR for children with above average intake reduced population obesity prevalence at 11 years by 1.5% but inequalities remained broadly unchanged. A targeted intervention for children of low-income families reduced prevalence by 0.7% and was found to slightly reduce inequalities.ConclusionsMSMs allow estimation of effects of simulated calorie-reduction interventions on childhood obesity prevalence and inequalities, although estimates are limited by the accuracy of reported calorie intake. Further work is needed to understand causal pathways and opportunities for intervention. Nevertheless, simulated intervention techniques have promise for informing national policy where experimental data are not available.

Child developmental and special education service receipt: The intersection of health and poverty

BackgroundChildren born of low birth weight (LBW) and/or premature may have developmental delays and difficulties. The vulnerability, without early intervention, would have detrimental lifelong effects. ObjectivesThis study examined 1) the relationship between LBW and prematurity and the occurrence and timing of children's receipt of developmental and special education services; and 2) whether poverty intersects with LBW and prematurity affecting service receipt. MethodsThis population-based study used cross-sectional data from the National Survey of Children's Health which consisted of approximately 52,000 participants aged 1–17 between 2017 and 2018 in the United States. We conducted logistic regression to analyze the predictive relationship of LBW/prematurity and the occurrence of receiving developmental and special education services. We then conducted ordered logistic regression to examine whether LBW and prematurity predicted the timing of receiving developmental and special education services. Further, we conducted moderating analyses to examine whether the predictive relationships above varied with poverty. The analyses listed above were weighted to reflect the population drawn. ResultsChildren born with LBW and prematurity were more likely to receive developmental and special education services and they tended to receive services earlier than those born at normal weight and term. Educational disparities were evident among children in low-income families. Children of LBW in low-income families were less likely to receive earlier services than those in affluent families. ConclusionsThis study indicates developmental and special education needs of children born LBW and/or premature. With restrained assets, low-income families may need more assistance to promote optimal development for their children.

Better Late Than Never: Effects of Late ACA Medicaid Expansions for Parents on Family Health-Related Financial Well-Being.

Public health insurance eligibility for low-income adults has improved adult economic well-being. But whether parental public health insurance eligibility has spillover effects on children's health insurance coverage and family health-related financial well-being is less understood. We use the 2016 to 2020 National Survey of Children's Health (NSCH) to estimate the effects of Medicaid expansions through the Affordable Care Act (ACA) for parents on child health insurance coverage, parents' employment decisions due to child health, and family health-related financial well-being. We compare children in low-income families in states that expanded Medicaid for parents after 2015 to states that never expanded in a difference-in-differences framework. We find that these expansions were associated with increases in children's public health insurance coverage by 5.5 percentage points and reductions in private coverage by 5 percentage points. We additionally find that parents were less likely to avoid changing jobs for health insurance reasons and children's medical expenses were less likely to exceed $1000. We find no evidence that the expansions affected children's dual coverage and uninsurance. Our estimates are robust to falsification and sensitivity analyzes. Our findings also suggest that benefits on children's medical expenses are concentrated in the families with the greatest financial need.

Fundamental movement skills and physical activity of children in low-income families

The purpose of the study was to determine the level of physical activity and basic movement skills in low-income families. The method used in this study is a quantitative descriptive method through surveys. The study sample included 32 children aged ± 9 years, consisting of 19 boys and 13 girls from low-income families. Sampling techniques use purposive sampling. The instruments used in the study were the population income category, the 2nd Edition Test of Gross Motor Development (TGMD), and the Instrument Physical Activities Questionnaire (IPAQ). The results showed that children in low-income families tend to have a body mass index underweight (thin), and basic movement skills are lacking. But in physical activity, boys tend to be moderate, and children tend to be low (low). This study is expected to be data on physical activity and basic movement skills in children from low-income families to be followed up through various activity programs in schools.

Risk of lead exposure, subcortical brain structure, and cognition in a large cohort of 9- to 10-year-old children.

Lead, a toxic metal, affects cognitive development at the lowest measurable concentrations found in children, but little is known about its direct impact on brain development. Recently, we reported widespread decreases in cortical surface area and volume with increased risks of lead exposure, primarily in children of low-income families. We examined associations of neighborhood-level risk of lead exposure with cognitive test performance and subcortical brain volumes. We also examined whether subcortical structure mediated associations between lead risk and cognitive performance. Our analyses employed a cross-sectional analysis of baseline data from the observational Adolescent Brain Cognitive Development (ABCD) Study. The multi-center ABCD Study used school-based enrollment to recruit a demographically diverse cohort of almost 11,900 9- and 10-year-old children from an initial 22 study sites. The analyzed sample included data from 8,524 typically developing child participants and their parents or caregivers. The primary outcomes and measures were subcortical brain structure, cognitive performance using the National Institutes of Health Toolbox, and geocoded risk of lead exposure. Children who lived in neighborhoods with greater risks of environmental lead exposure exhibited smaller volumes of the mid-anterior (partial correlation coefficient [rp] = -0.040), central (rp = -0.038), and mid-posterior corpus callosum (rp = -0.035). Smaller volumes of these three callosal regions were associated with poorer performance on cognitive tests measuring language and processing speed. The association of lead exposure risk with cognitive performance was partially mediated through callosal volume, particularly the mid-posterior corpus callosum. In contrast, neighborhood-level indicators of disadvantage were not associated with smaller volumes of these brain structures. Environmental factors related to the risk of lead exposure may be associated with certain aspects of cognitive functioning via diminished subcortical brain structure, including the anterior splenium (i.e., mid-posterior corpus callosum).

Psychological impact of home isolation on children aged 6-14 years during the COVID-19 pandemic in Tabuk, Saudi Arabia 2020.

Objectives:To evaluate the impact of home isolation on feelings and behaviors of children aged 6-14 years during COVID-19 pandemic in Tabuk, Saudi Arabia.Methods:A cross-sectional study was conducted between June and August 2020 in Tabuk, Saudi Arabia. A snowball sampling was applied, parents with children aged 6-14 years participated in this survey (N=361). questionnaires were distributed electronically.Results:Four out of ten children reported severe psychological impact on feelings (41.3%), while a majority of the children demonstrated mild psychological impact on behavior (74.8%). Age was associated with risk of psychological impact on behavior (OR: 7.24, 95% CI: 1.35-16.18). Being male was associated with risk of psychological impact on feelings (OR: 2.38, 95% CI: 0.67-6.43), and behavior (OR: 3.50, 95% CI: 0.42-6.00). Living in a small house or without an outside play area was associated with risk of psychological impact on feelings and behaviors.Conclusion:This study revealed that children experienced mild-to-severe psychological impact on behaviors and feelings during home isolation during COVID-19 pandemic. Priority should be given to boys, older age, children of low-income families, living in small houses and those without outside play areas.

Introduction

Previous articleNext article FreeForum: 25th Anniversary of Welfare ReformIntroductionLaura KawanoLaura KawanoForum Editor Search for more articles by this author Full TextPDF Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinked InRedditEmailQR Code SectionsMoreTwenty-five years ago, the structure of the social safety net in the United States was fundamentally changed. The federal Aid to Families with Dependent Children (AFDC) entitlement program was replaced with Temporary Assistance for Needy Families (TANF) — a block grant allocated to states and other subfederal regions. The new legislation introduced mandated work requirements and limited how long families could receive benefits, while giving states much discretion over how to spend funds. Around the same time, the Earned Income Tax Credit was enhanced to further support work among low-income families, and Medicaid was expanded to provide health insurance to children in low-income families. By prioritizing personal responsibility and work, advocates promised that these new policies would propel low-income families into self-sufficiency. However, concerns remained over whether states would adequately prepare cash assistance recipients to find work and how families would fare when they permanently lost access to benefits.The goal of these policies was to revamp the safety net in ways that would translate into long-run improvements for American families. On its 25th anniversary, this Forum presents three papers that examine how families have fared over this period. This long-run perspective is particularly useful, as these reforms were introduced during one of the longest economic expansions on record, making it difficult to disentangle their early effects from the strength of the underlying economy. The more recent US economic experience can help shed light on the longer-lasting effects of these policies during weaker economic times like the Great Recession and the more recent Pandemic Recession.The first paper by LaDonna Pavetti, Ali Safawi, and Danilo Trisi documents the contraction of the cash transfer system since the introduction of TANF, with particular attention to how these trends varied by geography and racial groups. They examine the role that the weakening of our cash assistance system has played in the increase of the number of families living in deep poverty and offer several recommendations for improving the program. The next two papers consider the effects of the bundle of policy changes that occurred and provide evidence that, on net, they did not lead to persistent disadvantages for those affected. The paper by Jeehoon Han, Bruce Meyer, and James Sullivan shows that along with the shift away from cash transfers documented in the first paper, tax and in-kind transfers increased. Focusing on single-mother-headed families, the main group targeted by these policies, they find that incomes for those in the bottom decile fell, but argue that this is due to an increase in the underreporting of income in surveys. Instead, when looking at measures of consumption, the material well-being of the worst off improved faster than for those higher up the consumption distribution. The final paper by Jacob Bastian, Luorao Bian, and Jeffrey Grogger shifts our attention to those who were adolescents at the time of safety-net reform and estimates its effects on their outcomes as young adults. They find that while women’s labor supply increased between the ages of 18 and 22, these gains did not persist into later ages, although it is difficult to separate the longer-run effects of safety-net reform from that of the Great Recession. Marriage rates among women fell, but there were no significant changes in childbearing, either out of wedlock or in total. While these latter two papers find some improvements for low-income families, they by no means imply that they are now well off.Today, proposals on both the political left and right make lifting children out of poverty a central goal. Analyses of the long-run effects of our most recent experience of sweeping safety-net reform hold important lessons for evaluating the potential paths that we might take. This Forum adds to the growing body of evidence on these effects. Previous articleNext article DetailsFiguresReferencesCited by National Tax Journal Volume 74, Number 3September 2021 Published for: The National Tax Association Article DOIhttps://doi.org/10.1086/716432 Views: 139 HistoryPublished online August 31, 2021 © 2021 National Tax Association. All rights reserved. Crossref reports no articles citing this article.

Universal School Meals in the US: What Can We Learn from the Community Eligibility Provision?

Changes in school meal programs can affect well-being of millions of American children. Since 2014, high-poverty schools and districts nationwide had an option to provide universal free meals (UFM) through the Community Eligibility Provision (CEP). The COVID-19 pandemic expanded UFM to all schools in 2020–2022. Using nationally representative data from the Early Childhood Longitudinal Study: Kindergarten Class of 2010–2011, we measured CEP effects on school meal participation, attendance, academic achievement, children’s body weight, and household food security. To provide plausibly causal estimates, we leveraged the exogenous variation in the timing of CEP implementation across states and estimated a difference-in-difference model with child random effects, school and year fixed effects. On average, CEP participation increased the probability of children’s eating free school lunch by 9.3% and daily school attendance by 0.24 percentage points (p < 0.01). We find no evidence that, overall, CEP affected body weight, test scores and household food security among elementary schoolchildren. However, CEP benefited children in low-income families by decreasing the probability of being overweight by 3.1% (p < 0.05) and improving reading scores of Hispanic children by 0.055 standard deviations. UFM expansion can particularly benefit at-risk children and help improve equity in educational and health outcomes.

Impact of state children’s health insurance program on fertility of immigrant women

ABSTRACT Between 1997 and 2000, all states in the United States (US) enacted the State Children’s Health Insurance Programme (SCHIP) to provide publicly funded health insurance coverage for children in low-income families. However, only 15 states including the District of Columbia initially chose to provide coverage for children of newly arrived immigrants in their SCHIP. We exploit the resulting state and time variation in the implementation of the programme in a difference-in-differences framework to estimate the effect of a publicly funded children’s health insurance benefit on immigrant women’s fertility. While estimates from full samples show that the net effect of the programme was indistinguishable from zero, we find a significant positive effect on the fertility of unmarried immigrant women, both at the extensive and at the intensive margin. Our findings have important policy implications for societies experiencing a persistent decline in fertility.

Dismantling Persistent Deficit Narratives About the Language and Literacy of Culturally and Linguistically Minoritized Children and Youth: Counter-Possibilities

Despite decades of efforts, deficit narratives regarding language development and use by children and students from historically marginalized backgrounds remain persistent in the United States. Examining selective literature, we discuss the ideologies that undergird two deficit narratives: the notion that some children have a “word gap” when compared to their White middle-class peers, and students must develop “academic language” to engage in rigorous content learning. The “word gap” concept came from a study wherein a group of young children in low-income families heard fewer words than those in middle-class families. It assumes that language can only be acquired in one way—vocabulary exchange from one parent to one child—and ignores decades of research on diverse pathways for language development. We highlight an alternative perspective that language development builds on children’s experience with cultural practices and the harm on minoritized children by privileging a specific form of vocabulary acquisition. The second deficit narrative concerns “academic language,” a concept championed by scholars aiming to address educational inequity. The construct runs the risk of undervaluing the potential of students from historically marginalized backgrounds to engage in learning using language that is “informal,” nonconventional, or “non-native like.” It also is sometimes used as a rationale to relegate students to special programs isolated from more rigorous academic discourse, thus ironically removing them from opportunities to develop the academic registers they are deemed to be missing. We explore alternative frameworks that shift the focus from linguistic features of academic talk and texts as prerequisites for academic work to the broad range of linguistic resources that students employ for academic purposes in the classroom. Finally, we turn to a positive approach to youths’ language development and use: translanguaging by multilingual learners and their teachers. Translanguaging demonstrates the power of a resource-oriented perspective that values students’ rich communicative repertoires and actively seeks to disrupt language hierarchies. We argue that this approach, however, must be considered in relation to the broader social context to meet its transformative aims. Together, our analysis suggests counter-possibilities to dismantle deficit-oriented narratives and points to promising directions for research and practices to reduce inequity in education.

The role of health at birth and parental investment in early child development: evidence from the French ELFE cohort.

This paper combines a theoretical and an empirical approach to address how health at birth affects child development. Using a simple theoretical model in which parents invest in their children, we identify the mechanisms through which better health at birth can improve child development. We also emphasise how parental socioeconomic status can shape the effects of health at birth. We perform an empirical analysis on a French cohort of children born in 2011, using a unique dataset ELFE. We identify the effect of birth weight and gestational age on child development at 1year. The results indicate that only gestational age positively affects early development. We find no empirical evidence for the existence of a severity effect, according to which the adverse effects of poor health at birth are higher for children in low-income families or with poorly educated mothers.

Associations of family income with cognition and brain structure in USA children: prevention implications

Poverty, as assessed by several socioeconomic (SES) factors, has been linked to worse cognitive performance and reduced cortical brain volumes in children. However, the relative contributions of the various SES factors on brain development and the mediating effects between cognition and brain morphometry have not been investigated. Here we used cross-sectional data from the ABCD Study to evaluate associations among various SES and demographic factors, brain morphometrics, and cognition and their reproducibility in two independent subsamples of 3892 children. Among the SES factors, family income (FI) best explained individual differences in cognitive test scores (stronger for crystallized than for fluid cognition), cortical volume (CV), and thickness (CT). Other SES factors that showed significant associations with cognition and brain morphometrics included parental education and neighborhood deprivation, but when controlling for FI, their effect sizes were negligible and their regional brain patterns were not reproducible. Mediation analyses showed that cognitive scores, which we used as surrogate markers of the children’s level of cognitive stimulation, partially mediated the association of FI and CT, whereas the mediations of brain morphometrics on the association of FI and cognition were not significant. These results suggest that lack of supportive/educational stimulation in children from low-income families might drive the reduced CV and CT. Thus, strategies to enhance parental supportive stimulation and the quality of education for children in low-income families could help counteract the negative effects of poverty on children’s brain development.

The impact of energy retrofits on pediatric asthma exacerbation in a Boston multi-family housing complex: a systems science approach

BackgroundPediatric asthma is currently the most prevalent chronic disease in the United States, with children in lower income families disproportionately affected. This increased health burden is partly due to lower-quality and insufficient maintenance of affordable housing. A movement towards ‘green’ retrofits that improve energy efficiency and increase ventilation in existing affordable housing offers an opportunity to provide cost-effective interventions that can address these health disparities.MethodsWe combine indoor air quality modeling with a previously developed discrete event model for pediatric asthma exacerbation to simulate the effects of different types of energy retrofits implemented at an affordable housing site in Boston, MA.ResultsSimulation results show that retrofits lead to overall better health outcomes and healthcare cost savings if reduced air exchange due to energy-saving air tightening is compensated by mechanical ventilation. Especially when exposed to indoor tobacco smoke and intensive gas-stove cooking such retrofit would lead to an average annual cost saving of over USD 200, while without mechanical ventilation the same children would have experienced an increase of almost USD 200/year in health care utilization cost.ConclusionThe combination of indoor air quality modeling and discrete event modeling applied in this paper can allow for the inclusion of health impacts in cost-benefit analyses of proposed affordable housing energy retrofits.

Safety Nets, Maternal Mental Health, and Child Mental Health Outcomes among Mothers Living in Poverty

Of the 40 million people living in poverty in the U.S., approximately 28% are single mothers and 18% are children. Low family income is linked with negative outcomes including higher rates of child mental health concerns. Due to limited public benefit availability, mothers often must rely on informal safety nets, or support from family or friends, to make ends meet. However, these informal safety nets are often coupled with burden, or obligations. To further increase their vulnerability, mothers living in poverty face higher levels of poor mental health. Also, both maternal mental health and safety nets can change over time. The purpose of this study was to examine informal safety nets, including informal support and burden, and maternal mental health and their longitudinal effects on mental health symptoms of children living in low-income families. Relying on data from the Welfare, Children, Families project, descriptive results showed change in informal safety nets, maternal mental health, and child mental health over time, with decline or multiple changes more common than improvement. Multilevel change models indicated safety nets and maternal mental health were associated with child outcomes such that mothers with minimal safety nets, higher psychological distress, and higher parenting stress had children with significantly higher mental health symptoms compared to children whose mothers had healthy safety nets and less distress. Findings speak to the importance of interventions that target both mothers and children in low-income families.